THE LEAST UNDERSTOOD ANXIETY DISORDER

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Social Anxiety Disorder/Social Phobia:
THE LEAST UNDERSTOOD ANXIETY DISORDER

Social anxiety is the fear of social situations and the interaction with
other people that can automatically bring on feelings of self-consciousness,
judgment, evaluation, and criticism. Put another way, social anxiety is the
fear and anxiety of being judged and evaluated negatively by other people,
leading to feelings of inadequacy, embarrassment, humiliation, and
depression. If a person usually becomes anxious in social situations, but
seems fine when they are alone, then "social anxiety" may be the problem.
Social anxiety disorder (social phobia) is a much more common problem than
past estimates have led us to believe. Millions of people all over the world
suffer from this devastating and traumatic problem every day of their lives,
either from a specific social phobia or from a more generalized social
phobia. In the United States, epidemiological studies have recently pegged
social anxiety disorder as the third largest psychological disorder in the
country.
A specific social phobia would be the fear of speaking in front of groups,
whereas generalized social anxiety indicates that the person is anxious,
nervous, and uncomfortable in almost all (or the majority of) social
situations.
People with social anxiety disorder usually experience significant emotional
distress in the following situations:
Being introduced to other people
Being teased or criticized
Being the center of attention
Being watched while doing something
Meeting people in authority ("important people")
Most social encounters, particularly with strangers
Making "small talk" at parties
Going around the room in a circle and having to say something
This list is certainly not a complete list of symptoms -- other feelings may
be associated with social anxiety as well.
The physiological manifestations that accompany social anxiety may include
intense fear, racing heart, turning red or blushing, dry throat and mouth,
trembling, swallowing with difficulty, and muscle twitches. Constant,
intense anxiety that does not go away is the most common feature.
People with social anxiety disorder know that their anxiety is irrational
and does not make "head" sense. Nevertheless, "knowing" something is never
the same as "believing" and "feeling" something. Thus, in people with social
anxiety, thoughts and feelings of anxiety persist and show no signs of going
away.
The good news is that cognitive-behavioral therapy for social anxiety
disorder has been markedly successful. People who have had this anxiety
problem for long periods of time have blossomed while in therapy. After
therapy, people with this problem report a changed life -- one that is no
longer totally controlled by fear and anxiety.
Social anxiety, as well as the other anxiety problems, can be successfully
treated. It always bothers me when I read that a person with social phobia
is just going to "learn to live with it". I want to scream. "No! You don't
have to live that way!"
But in seeking help for this problem, search for a specialist -- someone who
understands this problem well and knows how to treat it. Become an informed
client and ask questions. Do they understand that you feel very
self-conscious, that others are watching and forming a negative evaluation
about you - or do they minimize what you're saying and just say, "No, No,
No, you're exaggerating...." Now it is true that we who have gone through
social phobia do realize our mind is overexaggerating, but it still FEELS
like others are watching and judging us. Our self-consciousness is very
real. If your psychologist/mental health care worker does not understand
this, YOU KNOW MORE THAN THEY DO ABOUT SOCIAL ANXIETY. It is very doubtful
they will be able to help you.
Also, remember that the true professional will always welcome your
questions. If they seem stand-offish and unfriendly, they should not be your
choice of a therapist. Those of us who have or have had social anxiety need
support, encouragement, and a relatively stress-free environment while we
progress through therapy. Remember: This is YOUR time to get better and
heal. This is YOUR time to move forward away from the effects of anxiety,
fear, and avoidance.
Does your therapist say, "Face your fears and they'll go away?" Sorry, but
this therapist does not understand the dynamics of social anxiety. We have
constantly faced our fears ever since birth - we've HAD TO - and we feel
more fearful now than we did in the past. Seek another therapist. It is
imperative you find a psychologist who understands social anxiety
completely - because if they don't even know what it is - how will they know
what to do to help you overcome it?
Do they run a behavioral therapy group just for people with social phobia?
This is essential. If there is no social phobia therapy group involved, seek
treatment elsewhere. A behavioral therapy group is essential to your
ultimate success. (Note: We are not talking about a "support" group -- what
are we supporting anyway? The continuance of social phobia? Support groups
for people with social phobia do not help people overcome this anxiety
disorder. In fact, they may actually prevent progress.
Secondly, the group should not be a mixed anxiety group. Although the
anxiety experienced by all people with anxiety disorders is somewhat
similar, people with social phobia need precise, custom-tailored group
activities run by a specialist in this area. A social phobia therapy group
should only be for people with social phobia.
Getting over social anxiety disorder is not an easy task; yet many thousands
have already done it. While you're in the middle of the problem, it feels
hopeless - that you'll never ever get better. Life is just one gut-wrenching
anxiety problem after another. But this can be stopped, quenched, and
reduced in a relatively short period of time - but you must find a
cognitive-behavioral therapist who understands and specializes in the
treatment of social anxiety.
The most important elements in conquering social phobia are:
1. An understanding and awareness of the problem,
2. A commitment to carry through with cognitive-behavioral therapy even when
it seems difficult,
3. Practice, practice, practice to get that information deep down into your
brain so that it becomes automatic.
4. Participation in a social anxiety therapy group in which you can slowly
and gradually work on problems that cause you anxiety in the real world.
That is, the person who feels anxious while reading in public uses specific
strategies to meet his goal, whereas the person who wants to learn how to
make anxiety-free introductions and engage in small talk during social
activities slowly works toward her goals. We use role-plays, acting, the
tape recorder and video camera, question and answer periods, mock job
interviews, and doing foolish things deliberately as part of our behavioral
therapy group for people with social anxiety.
Note: We use a ladder or "hierarchy" as a flexible guide in our planning. We
want to practice, meet our goals, move up our expectations, meet our goals,
move up our expectations, until our goal is finally met. WE DO NOT PRESSURE,
PUSH, or CAJOLE. NO NEGATIVE tactic is employed because the individual must
choose to participate at her own pace. If she wants to sit there in group
and not say a word, that's O.K. No one will ever force her to do or say a
thing. But here's the secret: This has never happened! Everyone in the group
understands why they are there and, despite an amount of anxiety that is
present, they voluntarily choose to work on their specific anxieties. This
is much more practical and real-life than being forced to do something in a
group. While the therapist and the group should be encouraging and
motivating, the ultimate decision on progress resides within the person
himself.
Therapy groups should always be encouraging, positive, and supportive.
Social anxiety people are among the nicest people in the world. Go to a
meeting and find out......
It is impossible to stop a motivated person who refuses to give up
practicing. The role of the therapist is to know specifically what to do and
how quickly to do it. This sounds easy, but it is not. You must be
practicing the right material and you must proceed at the correct pace for
your own anxieties. You are more in control of this than your therapist.
Today, cognitive-behavioral therapy is used to treat both forms of social
anxiety. With cognitive-behavioral therapy, we do not wallow in the past and
continually bring it up --- because it doesn't do us any good. Instead, we
focus on present-day problems and symptoms and use many small techniques and
methods to eradicate anxiety thinking.
Here's where motivation and practice come in. The more you can practice
these small techniques at home, the quicker anxiety can be reduced and
social anxiety can be conquered.
-- Thomas A. Richards, Ph.D.,
Psychologist